The Medicare “Donut Hole”

2024-03-28T21:07:13-04:00December 17th, 2012|Categories: Costs for Treatment, eNews, Medication|Tags: |

The Coverage Gap The way Medicare Part D was designed there was a planned coverage gap, which has become known as "the donut hole". This gap has caused a great deal of confusion and higher than expected out of pocket costs for medications. When do you reach the gap? The gap begins when a person reaches a predetermined amount during the year based on average retail cost of drugs. In 2011, that amount is set at $2840. Since Medicare drug plans negotiate for a lower price the average retail cost is not what you actually paid out of pocket. Every drug [...]

Medicare and the Part D Donut Hole

2024-03-28T21:07:14-04:00December 17th, 2012|Categories: Costs for Treatment, eNews, Medication|Tags: |

An ounce of prevention is worth a pound of cure? This saying, made famous by Benjamin Franklin, is as true today as it was in the 1700's. Preventative care and early treatment can impact the outcome of most diseases. Mammograms and prostate screening are effective tools against cancer Sunscreens and limiting outdoor exposure to direct sunlight are effective methods to lower the risk for skin cancers The proper use of medication can also prevent conditions from forming or stop existing conditions from worsening. A potential growing gap is forming between what the doctor orders and what the patient may or may [...]

Dual Eligibility Medicare/Medicaid

2024-03-28T21:07:15-04:00December 17th, 2012|Categories: Costs for Treatment, eNews|

Dual Eligibility refers to a person being eligible in some way for both Medicare and Medicaid. Medicare is a federal program while Medicaid is a state program that is available to those with low income and/or resources. Medicare and Medicaid Medicare covers acute care services and Medicaid covers Medicare premiums and cost sharing expenses. Medicaid may also cover expenses for long term care. There are different types of eligibility and this link goes to a report with a table that outlines the differences http://www.medpac.gov/publications%5Ccongressional_reports%5CJune04_ch3.pdf Medicare is considered the primary insurer and covers medically necessary acute care services, including physician, hospital, [...]

Medicare and ESRD

2024-03-28T21:07:18-04:00December 17th, 2012|Categories: Costs for Treatment, eNews|

Medicare helps to pay for kidney dialysis as well as kidney transplants. Eligibility A person whose kidneys no longer work can get Medicare no matter what their age as long as they meet other criteria. You have worked long enough to qualify for retirement benefits from Social Security, the Railroad Retirement Board, or as a government employee You are already receiving retirement benefits You are the spouse or child or a person who meets either of the above criteria In order to receive full benefits you must apply for both Medicare Part A and B and wait the required amount [...]

Medicare 101

2024-03-28T21:07:19-04:00December 17th, 2012|Categories: Costs for Treatment, eNews|

Medicare Overview Most Americans have heard of Medicare, approximately 45 million people were receiving Medicare benefits in 2008. The Centers for Medicare and Medicaid Services (CMS) has predicted that there will be 78 million people eligible for the program by the year 2030. It might be expected that Medicare is very well understood, but the reality is that there are many pieces and parts that can be very confusing to the average person. A recent search on the internet for the term “Medicare” returned more than 16 million results in less than 1/10th of a second. It would take a person [...]

Kidney Patients and the Donut Hole

2024-03-28T21:07:20-04:00December 17th, 2012|Categories: Costs for Treatment, eNews, Medication|

Can the Medicare "Donut Hole" Affect Kidney Patients? The short answer to this question is "maybe". The longer answer reveals that the gap affects some Medicare recipients more than others. A closer look will help to explain the reason why these two answers are different and how your patient may be affected. What is it? The "donut hole" is a gap in prescription drug coverage under Medicare. This gap begins when a person reaches a predetermined amount during the year based on average retail cost of drugs. In 2011 the gap begins when a person spends $2840 in actual out of [...]

Managing Stage 5 Chronic Kidney Disease

2024-03-28T21:07:22-04:00December 14th, 2012|Categories: eNews, Medication, Nutrition, Stages of Kidney Disease|

As you are being treated for your chronic kidney disease (CKD) Stage 5, there are 2 areas of concern that you and your renal (kidney) care team should discuss. Diet Following a renal-friendly diet can help limit the amount of waste in your body, which will aid in your treatment. You and your renal dietitian can work together to monitor the foods you eat and the fluids you drink. Some things you may discuss include Limiting fluids Avoiding salt Being aware of hidden phosphorus Sticking to the diet you and your dietitian create may not only help you feel better, it [...]

Be a Part of Your Kidney Care Team

2024-03-28T21:07:24-04:00December 14th, 2012|Categories: eNews, Treatment|

Communicating Effectively with Your Kidney Care Team You go to dialysis and stay for the entire session. You take your medication as directed by your doctor. You follow your kidney care team’s instructions. Is there anything else you can do to manage your condition? There is. Learn to talk and work with your kidney care team so you understand their expectations and they understand yours. Communicating with your kidney care team is more than just listening to them. It’s asking questions, letting them know your thoughts, and taking action. Be specific when talking with your kidney care team and Write down [...]

Care for Your Overall Health

2024-03-28T21:07:25-04:00December 14th, 2012|Categories: Early Intervention, eNews, Immunizations, Lifestyle|

Preventive Screenings Part of managing chronic kidney disease (CKD) is keeping up with medical screenings. Talk with your doctor every January about “preventive maintenance” screenings you’ll need for the coming year, and mark them on a calendar. The tests you need depend on your age, your health, and whether you are male or female, so work with your nephrologist to ensure that your tests are done as necessary. Below are some examples of tests recommended by the US Department of Health & Human Services for the average person: General Tests Cholesterol test Blood pressure test Diabetes screening Fecal blood test Mental [...]

Managing Your Time Wisely Around Treatment

2024-03-28T21:07:26-04:00December 14th, 2012|Categories: Dialysis, eNews, News & Events, Treatment|

Scheduling Activities and Tasks Your time at your dialysis treatment or doctor appointments is a great opportunity to take care of all the things that are a part of your daily life. Use this time to your advantage. Talk to others with kidney disease. They can be a source of strength and support, and they may also be able to give you tips on how to stick with your treatment plan Learn about something interesting like a new language or photography Bring a sketchbook and practice drawing Bring your kidney-friendly cookbook and plan meals for the week Strengthen your mind with [...]

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